Part 1: Eleven Ways to Slow Aging

In Part II, I dive deep into the shared behaviors of people in the world’s five Blue Zones, the regions whose residents live the longest. In building the optimal anti-aging plan, I examine the best and worst foods and beverages. Does red wine deserve its status as a symbol of longevity? And coffee? I cover the “longevity vitamin” ergothioneine, the vegetarian’s Achilles’ heel, and the best exercise and sleep program for the longest, healthiest life.

Part 3: Preserve Function

Then, in Part III, I get down to business. What can you do to preserve your bones, your digestion, your circulation? Your hair, your hearing, your hormonal balance? Your immune function and your healthy joints? Your mind and your muscles? Your sex life and your skin? Your teeth, your vision, and finally your dignity in death? Each of these points gets a chapter. For a little preview, go to see.nf/trailer.

Part 4: Dr. Greger’s Anti-Aging Eight

My Anti-Aging Eight make up the final section of the book, an actionable checklist that complements the so-called Daily Dozen from my book How Not to Die. In addition to the many recommendations I make throughout How Not to Age, in this final part I highlight specific foods, supplements, or behaviors that have the potential to slow the aging process or promote longevity. My goal is, based on the best available scientific evidence, to illuminate every possible angle for developing the optimal diet and best lifestyle for the longest, healthiest lifespan.

1. Eleven Ways to Slow Aging

Introduction

It has long been said that you can have the best hopes for a long life if you choose your parents wisely. Doesn’t longevity run in families? Siblings of centenarians do, in any case, have a greater likelihood of becoming at least 100 themselves, and it’s more likely that their parents lived to at least 90. On the other hand, the lifespans of spouses sometimes correlate as strongly as those of genetic relatives—or even more strongly. Your partner’s influence might be as great as your parents’. After all, we don’t just inherit genes. It’s possible that Grandma’s healthy recipes, or even a lifelong love of running, also run in the family.

How important are your genes?

To tease out the role of genetics, researchers often turn to twin studies that compare differences between identical and fraternal twins. Go to see.nf/genes to understand exactly how this ingenious method estimates heritability and what has been found using it and other methods. In short, only about 15 to 30 percent—or even less—of our lifespan seems to be predetermined by our genes, which means that how we live our lives largely determines our destiny.

To take advantage of the room we have in our lifespan beyond the relatively small genetic component, we first need to understand the different pathways of aging. The term “anti-aging” has been heavily abused in mass culture and lumped together with all sorts of products and procedures with no proven effect. Perhaps the term should be reserved for factors that halt or reverse the aging process by targeting one or more of the established mechanisms of aging. In a groundbreaking paper that has been cited more than 7000 times in the biomedical literature, nine commonalities of the aging process are identified as the “hallmarks of aging.” In see.nf/genes I explain them in detail, and I also address them individually in this book.

A fly in my anti-aging soup!

There are many ways to solve the mysteries of aging. For example, you could study long-lived individuals like centenarians and supercentenarians, or particularly long-lived smokers, to uncover the secret of their resilience. Or, conversely, you could study short-lived people, investigate tragic syndromes of accelerated aging like progeria, in which children age eight to ten times faster than normal, develop wrinkles, lose their hair, and then usually die at around 13 from a heart attack or stroke. Or you can study long-lived animals. There is a clam, the ocean quahog, whose heart beats more than a billion times over the course of its 500-year lifespan.

In my video see.fn/models, I talk about both the possibilities and difficulties of extrapolating from the “model organisms” in aging research—yeasts, worms, flies, and mice—as well as citizen-science projects in which family dogs are studied in noninvasive studies to find out why “Methuselah dogs” live to be more than 25 years old, but 99.9 percent of dogs do not. Older dogs often suffer from the same age-related ailments as we do, such as arthritis, cancer, cataracts, kidney problems, and muscle loss. Advances in dog longevity may be useful not only for human aging, but have value in their own right, since they increase the quality and quantity of life for the more than 70 million four-legged companions with whom we share our homes in the United States alone.

AMPK

In my book How Not to Diet, there is a section titled “AMP-activated protein kinase.” AMPK is an enzyme that serves plants and animals as a sensor, similar to the gas gauge in a car. It rises when it detects a shortage of universal fuel, the way a light comes on on your dashboard when you’re running out of gas. AMPK flips the switch in the body from fat storage to fat burning to restore energy balance. That’s why AMPK is known not only as the body’s master energy sensor, but also as a fat regulator. That’s why it played a starring role in How Not to Diet. But it can do more than regulate weight. It can regulate aging.

In times of abundance, our cells run at full throttle. In times of scarcity, however—when an animal doesn’t get enough food or a plant doesn’t get enough light (darkness is the famine of plants)—AMPK steps in to put cells into maintenance mode and tap energy reserves, such as burning body fat. In addition, the cells initiate a recycling program called autophagy.

Autophagy is a kind of housecleaning in which damaged cellular components—for example, malformed proteins that could have built up wastefully in times of abundance—are broken down and used as spare parts. As I show in detail in the chapter on autophagy, it functions both as recycling and as garbage disposal. Scarce raw materials are reused, and some of the accumulated debris associated with the aging process is broken down. This is one reason AMPK is increasingly recognized as a longevity factor. AMPK switches on autophagy, which cleans house, removes waste, and practically resets the cells.